Guide to Calculating Money Compensation for Personal Injuries
We can agree that we choose health over money. However, if you are injured you deserve to be fairly compensated. I started as a San Diego personal injury lawyer since 2005 fighting for the rights of injured victims. I have helped clients in San Diego, Los Angeles, Ventura County, Riverside County, and Orange County. My experience includes working at prestigious national law firm, Bremer Whyte etl. al., defending large insurance companies and their insured in multi-million-dollar cases. I will ensure you get the maximum compensation for suffering an injury.My success is measured in the real differences made to my clients’ quality of life.
Reliance on the adjuster’s injury calculator may be misleading and result to unfair compensation. The guidelines below demonstrate how you can conduct the calculation of the value of an injury claim.
Determination of the actual monetary compensation that adequately represent the incurred losses can be challenging. This situation emerges from lack of dedicated formula to determine the exact value.
Each injury claim is unique, and the settlement relies on the context of the occurrence of the personal injury. A vital approach is careful assessment of the lost income, resultant medical charges, and emotional turmoil that the injury may cause.
On this page you will learn about calculating the value of your personal injury from an accident. The following section outlines the underlying components that insurance companies may rely upon to calculate or discredit an insurance claim against you.
What is the Value of my Injury Claim?
Regardless of the injury, loss is inevitable. In the insurance jargon, the word “damages” is used to depict these losses.
The insurance regimen classifies damages in two distinct classes:
- Special Damages: This category is also referred to as economic damages and pertains the measurable monetary loss incurred and may keep losing because of the negligence by the condemned party. Factors such as wage losses and healthcare bills are considered “specials.”
- General Damages: These are non-physical losses that the aggrieved party endures or will continue to sustain from the injury. Intangible factors such as trauma and pain fall under this category.
Calculation of Special Damages
Your calculation of special damages involves the cumulative cost of the monetary losses incurred due to the injury.
Special Damages entail the hard costs in dollar amounts incurred from:
- Wage losses of the past and the future.
- Medical charges, such as physiological therapy, nursing care, and drug therapy.
- Overhead expenses, including crutches, transportation charges, and consultation fees during physician appointments.
- Nonremunerated expenses including yard work, childcare expenditure, and housekeeping maintenance charges during the period of incapacitation.
- The value of personal items lost or those that got damaged due to injury.
The cumulative value of the special damages forms the basis of the valuation of personal injury claims. It is noteworthy that an injury claim is virtually inconsequential when devoid of medical bills.
It is imperative to account for every cent utilized in the healthcare bills regardless of the fact that some of the charges may have been partially or wholly covered by your healthcare plan.
Occasionally, some of the treatment services may consist of multiple bills, for instance:
The body imaging services, including the Magnetic Resonant Imaging (MRI), Computed tomography (CT) Scans, or X-Rays often contain the billing information from the facility and a separate invoice for the physician that interpreted the outcome. Similarly, the emergency department also bills separately from the emergency treatment room where the patient receives treatment.
Calculation of the General Damages
Given the special circumstances of every personal injury, the calculation of general damages presents a special challenge to the aggrieved party and the insurance company. Oftentimes, this category entails hard-to-assess intangible factors.
For instance, pain is a difficult factor to quantify because it depends on multiple aspects such as the endurance threshold of the affected person, the extent of the injury, and the time it takes to recover. The fact that two people may have an exact type of injury does not mean that they will experience the same amount of pain. One of them may descent into depression, whereas another one may be stoic. Besides, the same injury may incapacitate one person from working, while the other may continue with daily activities unaffected.
Examples of General Damages
- Physiological impacts such as pain and aching.
- Loss of the ability to concentrate
- Panic attacks.
- Emotional distress.
Gaining a fair estimation of your pain and emotional distresses requires multiplication of the total special damages once or twice. In most cases, insurance organizations accept multiples of one or twice the amount of the specials if the severity of the injury ranges from mild to moderate.
However, acute injuries may require you to enlist the services of a specialist attorney in matters of personal injury to secure a fair compensation for the emotional distress, suffering or pain that you sustained from the ordeal.
High-Compensation personal injury requires more factors to calculate including:
- Extreme mental torment: Intensive mental suffering attracts higher monetary compensation. However, this case can only be proved by a qualified mental health practitioner. Nonetheless, it is easier to demonstrate this type of general damage if the sustained injuries require the involvement of a psychological expert before regaining normalcy.
- Persistent injuries or incessant pain: If the treatment plan entails invasive interventions, including surgical incisions, amputation, scarring or even permanent incapacitation of some body arts then a higher value for general damages is imperative.
- Shocking events: Traumatic events, including accidents, capsizing, plane crashes, shootings, or entrapment in a burning automotive can raise the threshold for claiming higher compensation in general damages.
Generally, the valuation process for general damages is highly dependent on the special circumstances surrounding the injurious event. It is only you who can determine the extent of emotional distress, pain or suffering that results from the injury. Similarly, the burden of proof to the insurance company is entirely yours. The best approach in such circumstances is to embrace the thinking of an adjuster to claim higher resettlement for the damages.
Presenting your compensation Demands
Before receiving any monetary compensation, you or your attorney have the onerous responsibility to prove to the insurance agency that:
- The company’s insured owes you the duty of care, which implies they have a responsibility to protect you from harm.
- The insured demonstrated negligence through action or omission that amounted to irresponsibility on their pat.
- The negligence of the insured entity or person is the direct cause of the sustained injury.
- The insured has total liability for the injury and all the associated damages.
Most importantly, you must gather all the evidential materials including photographic or videotaped content, treatment records, image scans, statements from witnesses, and other supporting documentation to back your claim against the company.
In case you elect to handle you own claim negotiations, the initial step is to compile a written application for compensation.
The compensation demand refers to the cumulative monetary equivalent of the amount you believe is a fair settlement for the injury claim. This demand must be accompanied by supporting documentation and evidential material.
Therefore, calculation of the demand is calculated by addition of the special damages, and the value of general damages. The total value is the compensation demand.
Make your claim look professional by utilizing out template for a Personal Injury Demand Letter.
The Personal Injury Calculation and Insurance Agencies:
Insurance adjusters seldom agree to offer you the initial amount that you propose in the demand letter.
The adjusters from the company conduct a careful review of the demand to determine whether the damages that you claim are concomitant with the attached evidence.
One of the core objectives in the review is to determine the liability of their insured to the injury. Then the professionals will undertake a second check to assess the legitimacy of the presented evidence.
Regarding the general damages, the adjuster has to compare your proposed value and make a determination on its appropriateness. In case of a discrepancy, the adjuster offers his or her suggestion of the amount that is reasonable.
Given the fact that general damages entail subjective and intangible factors such as pain and suffering, the adjuster is likely to come up with a different compensation amount from your proposal. Consequently, this part comprises the finer details of settlement negotiations, in which you must perfect the art of presenting a convincing argument that is backed by evidence.
Claim payouts in settlement of demands can cause immense financial losses to the insurance company. Therefore, these agencies have embraced digital computer algorithms to aid in calculation and saving more money. The Colossus is one of the most ubiquitous calculators in this exercise.
The Colossus software is specifically designed to work conduct personal injury calculation in insurance organizations. The program intelligently assigns values to special damages claims, and other aspects that are associated with personal injury claims. Colossus utilizes hundreds of variables, including scenarios where the aggrieved party has enlisted the services of an attorney or the average amount that is offered to settle similar claims of personal injury.
Regrettably, a software application such as Colossus can only work out the special damages. However, its accuracy on general damages, including pain or suffering is limited because computerized algorithms cannot understand the incalculable aspects of an injury such as stress. The best it can try is based on artificial intelligence that it gleans from statistics, and these statistical values can never accurately depict the amount of human suffering due to injury.
Factors that Impact Calculation of Injury Claims
Cases that entail a complex litigation process, such as product malfunction, organization-wide malpractices, injuries during birth, or injuries that can be levelled against corporate sector respondents, you must enlist the services of an expert personal injury attorney.
Oftentimes, people sustain personal injuries from motor vehicle accidents, or falls on slippery surfaces. Besides, attacks from aggressive pets such as dogs, or disparate forms of negligence are also frequent causes of personal injury. In most cases, these events imply that we have to engage insurance companies to compensate the personal injuries that we suffer.
There are numerous factors that can impact the personal injury calculations and the amount of claim payouts from the insurance companies.
Policy Restrictions: In the event that the personal injury cost becomes higher than the insurance limits of the company, the only alternative is to seek legal redress by suing the person at-fault to cater for the payment difference.
Shared liability: More often than not, adjusters peruse the demand submissions with an aim of shifting some extent of the blame on the aggrieved party. In some states, the shared blame can cause denial of a claim. Besides, according to the 50-percent rule, if half of the blame is proven to be your responsibility, then you might not get compensation.
Exacerbated Medical Bills: An insurance company can only settle claims for medical expenses that are necessary and are considerably reasonable. However, if the injury doctor chooses to inflate the healthcare bills by incorporating unwarranted tests, treatments, then the adjuster may expunge them from the list of payable claims.
Location: In most cases, the adjuster may prefer to make settlements out of court if he or she believes that the juries may side with the injury victim.
The Attorneys raise the Amount of Compensation
Straight-forward injury claims or minor accidents can be handled with the company without protracted legal engagements.
The adjusters are often hired by the insurance organizations with an overarching objective to settle claims competently and without elongating the process. Therefore, they try to avoid the eventuality of law suits as much as possible.
In case there is a disagreement with the adjuster and the claim proceeds to a trial, there are more chances that the jury will arrive at a judgment that involves thousands of dollars more than an out-of-court settlement.
Alternatively, the court outcome is never predictable. Therefore, it is often advisable to engage an experienced injury attorney to negotiate a reasonable settlement with the adjusters instead of resenting the matter in a court of law.
Notably, you should remember that insurance companies have penchant for arriving at a lower settlement than the one demanded by the claimant. Given their experience in the business, most companies know an amount that when offered may impede your judgement to claim for more money.
You can avoid getting a raw deal by contacting reputable personal injury attorneys. Most of them offer initial consultation at zero cost. Therefore, strive to know what an experienced attorney can do for you before you engage the insurance company.